1
|
Ma D, Liu Z, Loh LJ, Zhao Y, Li G, Liew R, Islam O, Wu J, Chung YY, Teo WS, Ching CK, Tan BY, Chong D, Ho KL, Lim P, Yong RYY, Panama BK, Kaplan AD, Bett GCL, Ware J, Bezzina CR, Verkerk AO, Cook SA, Rasmusson RL, Wei H. Identification of an I Na-dependent and I to-mediated proarrhythmic mechanism in cardiomyocytes derived from pluripotent stem cells of a Brugada syndrome patient. Sci Rep 2018; 8:11246. [PMID: 30050137 PMCID: PMC6062539 DOI: 10.1038/s41598-018-29574-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 07/16/2018] [Indexed: 02/08/2023] Open
Abstract
Brugada syndrome (BrS) is an inherited cardiac arrhythmia commonly associated with SCN5A mutations, yet its ionic mechanisms remain unclear due to a lack of cellular models. Here, we used human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) from a BrS patient (BrS1) to evaluate the roles of Na+ currents (INa) and transient outward K+ currents (Ito) in BrS induced action potential (AP) changes. To understand the role of these current changes in repolarization we employed dynamic clamp to “electronically express” IK1 and restore normal resting membrane potentials and allow normal recovery of the inactivating currents, INa, ICa and Ito. HiPSC-CMs were generated from BrS1 with a compound SCN5A mutation (p. A226V & p. R1629X) and a healthy sibling control (CON1). Genome edited hiPSC-CMs (BrS2) with a milder p. T1620M mutation and a commercial control (CON2) were also studied. CON1, CON2 and BrS2, had unaltered peak INa amplitudes, and normal APs whereas BrS1, with over 75% loss of INa, displayed a loss-of-INa basal AP morphology (at 1.0 Hz) manifested by a reduced maximum upstroke velocity (by ~80%, p < 0.001) and AP amplitude (p < 0.001), and an increased phase-1 repolarization pro-arrhythmic AP morphology (at 0.1 Hz) in ~25% of cells characterized by marked APD shortening (~65% shortening, p < 0.001). Moreover, Ito densities of BrS1 and CON1 were comparable and increased from 1.0 Hz to 0.1 Hz by ~ 100%. These data indicate that a repolarization deficit could be a mechanism underlying BrS.
Collapse
Affiliation(s)
- Dongrui Ma
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, 169609, Republic of Singapore
| | - Zhenfeng Liu
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, 169609, Republic of Singapore
| | - Li Jun Loh
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, 169609, Republic of Singapore
| | - Yongxing Zhao
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, 169609, Republic of Singapore
| | - Guang Li
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, 169609, Republic of Singapore
| | - Reginald Liew
- Cardiovascular & Metabolic Disorders Program, Duke-NUS Medical School Singapore, Singapore, 169857, Republic of Singapore
| | - Omedul Islam
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, 169609, Republic of Singapore
| | - Jianjun Wu
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, 169609, Republic of Singapore
| | - Ying Ying Chung
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, 169609, Republic of Singapore
| | - Wee Siong Teo
- Department of Cardiology, National Heart Centre Singapore, Singapore, 169609, Republic of Singapore
| | - Chi Keong Ching
- Department of Cardiology, National Heart Centre Singapore, Singapore, 169609, Republic of Singapore
| | - Boon Yew Tan
- Department of Cardiology, National Heart Centre Singapore, Singapore, 169609, Republic of Singapore
| | - Daniel Chong
- Department of Cardiology, National Heart Centre Singapore, Singapore, 169609, Republic of Singapore
| | - Kah Leng Ho
- Department of Cardiology, National Heart Centre Singapore, Singapore, 169609, Republic of Singapore
| | - Paul Lim
- Department of Cardiology, National Heart Centre Singapore, Singapore, 169609, Republic of Singapore
| | - Rita Yu Yin Yong
- Defense Medical and Environmental Research Institute, DSO National Laboratories, Singapore, 117510, Republic of Singapore
| | - Brian K Panama
- University at Buffalo, State University of New York, Buffalo, NY, 14214, USA
| | - Aaron D Kaplan
- University at Buffalo, State University of New York, Buffalo, NY, 14214, USA
| | - Glenna C L Bett
- University at Buffalo, State University of New York, Buffalo, NY, 14214, USA
| | - James Ware
- Imperial College London, South Kensington Campus, London, SW7 2AZ, UK
| | - Connie R Bezzina
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Arie O Verkerk
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Stuart A Cook
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, 169609, Republic of Singapore.,Cardiovascular & Metabolic Disorders Program, Duke-NUS Medical School Singapore, Singapore, 169857, Republic of Singapore.,Imperial College London, South Kensington Campus, London, SW7 2AZ, UK
| | - Randall L Rasmusson
- University at Buffalo, State University of New York, Buffalo, NY, 14214, USA.
| | - Heming Wei
- National Heart Research Institute Singapore, National Heart Centre Singapore, Singapore, 169609, Republic of Singapore. .,Cardiovascular & Metabolic Disorders Program, Duke-NUS Medical School Singapore, Singapore, 169857, Republic of Singapore.
| |
Collapse
|
2
|
Musunuru K, Sheikh F, Gupta RM, Houser SR, Maher KO, Milan DJ, Terzic A, Wu JC. Induced Pluripotent Stem Cells for Cardiovascular Disease Modeling and Precision Medicine: A Scientific Statement From the American Heart Association. CIRCULATION. GENOMIC AND PRECISION MEDICINE 2018; 11:e000043. [PMID: 29874173 PMCID: PMC6708586 DOI: 10.1161/hcg.0000000000000043] [Citation(s) in RCA: 125] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Induced pluripotent stem cells (iPSCs) offer an unprece-dented opportunity to study human physiology and disease at the cellular level. They also have the potential to be leveraged in the practice of precision medicine, for example, personalized drug testing. This statement comprehensively describes the provenance of iPSC lines, their use for cardiovascular disease modeling, their use for precision medicine, and strategies through which to promote their wider use for biomedical applications. Human iPSCs exhibit properties that render them uniquely qualified as model systems for studying human diseases: they are of human origin, which means they carry human genomes; they are pluripotent, which means that in principle, they can be differentiated into any of the human body's somatic cell types; and they are stem cells, which means they can be expanded from a single cell into millions or even billions of cell progeny. iPSCs offer the opportunity to study cells that are genetically matched to individual patients, and genome-editing tools allow introduction or correction of genetic variants. Initial progress has been made in using iPSCs to better understand cardiomyopathies, rhythm disorders, valvular and vascular disorders, and metabolic risk factors for ischemic heart disease. This promising work is still in its infancy. Similarly, iPSCs are only just starting to be used to identify the optimal medications to be used in patients from whom the cells were derived. This statement is intended to (1) summarize the state of the science with respect to the use of iPSCs for modeling of cardiovascular traits and disorders and for therapeutic screening; (2) identify opportunities and challenges in the use of iPSCs for disease modeling and precision medicine; and (3) outline strategies that will facilitate the use of iPSCs for biomedical applications. This statement is not intended to address the use of stem cells as regenerative therapy, such as transplantation into the body to treat ischemic heart disease or heart failure.
Collapse
|